1. Carlson, Elizabeth A.

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In 2004, the America Association of Colleges of Nursing (AACN) endorsed the Position Statement on the Practice Doctorate in Nursing, which stated that the Doctor of Nursing Practice (DNP) as the single-entry degree for advanced practice nurses. This endorsement was important because AACN "is the national voice for America's baccalaureate- and higher-degree nursing education" (AACN, 2015). The target date of 2015 was set as a goal for the transition of advanced practitioner registered nurses (APRNs) programs to the DNP level for entry to advanced practice. We are in 2015 and you may see or hear more discussion about the DNP and preparation for APRNs at the DNP level. Thus, there are a few important documents of which you should be aware and a few books that will further your understanding of the DNP and advanced practice nurses.


The primary site for comprehensive information about the DNP is the AACN site Once on the homepage, the easiest way to find information on the DNP is clicking on Leading Initiatives and scrolling down to Doctor of Nursing Practice. There are many options from which to choose. If you are not familiar with the DNP, begin with the tab labeled About the DNP. The materials accessible here provide a historical perspective and the thinking behind the development of the DNP. The next tab, Position Statement, is the 2004 statement cited previously and served as the foundational document upon which the DNP was developed. Included in the 2004 Position Statement are the essentials for the practice doctorate. These Essentials are enumerated in excruciating detail in the next section/tab titled DNP Essentials. As an educator, I have spent many hours with this document because the DNP programs are reviewed using these essentials. The reason I suggest reviewing them is that the Essentials offer the reader a comprehensive overview of the terminal objectives or outcomes one is expected to meet upon completion of a DNP program.


The next tab, DNP Toolkit, is primarily for use by colleges of nursing in the development of a DNP program. The tab labeled, Program Directory, lists by state all colleges of nursing that currently offer the DNP degree program. There is an extensive list of colleges in 48 states and the District of Columbia that offer the DNP degree.


The current status of what has been accomplished toward the 2015 goal for the transition to the postbaccalaureate DNP is available by clicking on the primary DNP tab under which the tabs cited earlier are located. The RAND study is titled "The DNP by 2015: A Study of the Institutional, Political, and Professional Issues That Facilitate or Impede Establishing a Post-Baccalaureate Doctor of Nursing Practice Program." Some key findings that can be read in more detail under the Talking Points header in the report include that more than 250 colleges of nursing have DNP programs; that the master's degree route remains the dominant route into APRN practice at this time; there are 30% of colleges that offer the BSN to DNP with the expectation that this proportion will rise to 50% over the next few years; and that a concern exists that employers are unclear as to the differences in outcomes between an MSN- versus a DNP-prepared APRN.


Whether you are an employer with questions about the DNP-prepared APRN or a nurse considering further education, there are some books available that offer examples of how DNP-prepared APRNs function and what they bring to the organization that differs from an MSN-prepared APRN. There are two books I recommend. The DNP Capstone Projects: Exemplars of Excellence in Practice edited by Barbara A. Anderson, Joyce M. Knestrick, and Rebecca Barroso, and The Doctor of Nursing Practice Scholarly Project: A Framework for Success by Katherine Moran, Rosanne Burson, and Dianne Conrad.


The 2015 book, DNP Capstone Projects: Exemplars of Excellence in Practice edited by Barbara A. Anderson, Joyce M. Knestrick, and Rebecca Barroso and published by Springer Publishing Company, New York, costs U.S.$75.00 and is 190 pages in length. This is an excellent book for both potential students and employers to read. It is easily read and understood and offers useful information.


The foreword by Melnyk details why AACN endorsed the DNP as the single-entry degree for APRNs. Melnyk succinctly frames the need for DNP-prepared APRNs and the benefits that result from the evidence-based projects developed and managed by DNP-prepared APRNs. Confusion around the preparation and role of individuals with the practice doctorate (DNP) versus the research doctorate (PhD) exists as a result of some DNP programs requiring students to conduct capstones that are original research and as Melnyk points out, this book with nine DNP exemplars helps reduce this confusion.


Section I provides the reader with the background information necessary to understand the foundation upon which DNP capstones are constructed. Chapter 1, The Emergence and Impact of the DNP Degree on Clinical Practice, traces the numerous issues, policies, and patient/consumer needs that lead to the development of the DNP. Berkowitz looks at the evolution of nursing, the development of the DNP role, the variations and challenges encountered, and the need to achieve clinical value. Chapter 2 details Robert Morris University's journey to open one of the first BSN to DNP programs accredited by the Commission on Collegiate Nursing Education in 2010. Of interest is the evolution of the DNP capstone as the program progressed. There is an informative table (Table 2.1, pp. 22-23) showing the timeline for a BSN-DNP capstone project. This timeline offers an excellent example of the type of work and how it progresses for anyone interested in understanding the "nitty-gritty" of a DNP program. This chapter also discusses the difference challenges encountered by BSN to DNP students versus MSN to DNP students and possible solutions.


In Chapter 3, the central relationship between the use of evidence-base practice and the DNP Essentials is presented. Using the most pertinent DNP Essentials as a basis for discussion, further explanation assists in understanding the DNP and the concepts upon which it is based. The remainder of the chapter walks the reader through the development of a DNP capstone project offering another view of the education involved in the DNP. This is very useful information for anyone considering obtaining the DNP.


Section II is DNP Exemplars: Excellence in Practice. Nine capstone projects are presented. These examples are from different practice sites and address different practice issues. The thinking and work involved in the development of a DNP capstone project illustrate what a DNP is and does and how the DNP-prepared APRN brings value to the employer. I highly recommend this entire book, but in particular Section II is worth reading.


Section III has two chapters. Chapter 13 looks at the impact made by DNP projects on quality and safety in healthcare organizations. The examples presented in Chapter 13 offer the reader more examples of the outcomes associated with improvement projects led by DNP-prepared APRNs. The last chapter discusses the importance of dissemination of DNP practice scholarship because without dissemination others cannot benefit from the improved healthcare outcome.


I highly recommend this book to both individuals who may be interested in pursuing a DNP and those who may or do employ DNP-prepared APRNs. In 191 pages, the reader gains a strong understanding of what is involved in DNP education and how the DNP-prepared APRN improves care.


Another book that offers understanding related to the DNP is The Doctor of Nursing Practice Scholarly Project: A Framework for Success by Katherine Moran, Rosanne Burson, and Dianne Conrad. It was published in 2014 by Jones and Bartlett Learning, Burlington, MA, costs U.S.$ 99.95, and is 430 pages long. The purpose of the book was "to provide a road map for DNP students to use on their journey from project conception through completion and dissemination" (pp. xxiv). The authors begin this book in Section I with a discussion about the DNP scholarly or capstone project. They chose this approach on the basis of the belief that entering a DNP program begins the process of transformation of the participant into a scholar. I would agree that this is a key outcome of the DNP. The remainder of Section I discusses what to expect in a DNP program, what the trends are, and what scholarship is. In Chapter 3, there is a brief but useful comparison of the PhD and DNP. In Chapter 4, Scholarship in Practice, the definition of scholarship, how it has evolved, and its relationship to practice is discussed. The discussion on Types of Scholarship beginning on page 63 leads the reader through the differences in types of scholarship and offers an additional, very useful comparison of types of scholarship resulting from the PhD versus the DNP.


Section II: The Scholarly Project, with its nine chapters, steps the reader through the project process from conceptualization to implementation. Useful examples and explanations are found within these chapters that help the reader, especially someone considering pursuing this degree, understand the processes used for the project. Chapter 10 presents the role of the practicum and how it impacts the project. Section III: Doctor of Nursing Practice Outcomes looks at evaluating the project and communicating the results. The final chapter, The Rest of the Story-Evaluating the Doctor of Nursing Practice, discusses how the degree needs to be evaluated for effectiveness in accomplishing the goals of improved care and quality for healthcare and society.


Similarly to the previous book reviewed, I highly recommend this book to both individuals who may be interested in pursuing a DNP and those who may or do employ DNP-prepared APRNs. Although the content is similar in each book, the second book by Moran, Burson, and Conrad offers more detailed explanations of the how-to of the DNP capstone project, while the first book by Anderson, Knestrick, and Barroso presents completed DNP capstones that readers can relate to their clinical practice areas. I also recommend the AACN website as an excellent place to start your inquiry into the DNP and the results of the 2015 mandate for APRNs being prepared at the doctoral level.